Is it time to talk about coronavirus?

ManW_TheUncool

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I understand the testing data has too much noise and is not reliable at all to draw conclusions... but if we must conclude anything about the "curve" based on that data, it seems to me the "curve" is indeed flattening because the rate of daily increase has been going down lately -- even pretty substantially so last few days.

Now, as I (and some others) have been saying pretty much all along, the testing data simply isn't reliable at all for such determination, so...

IF we're actually talking about the deaths chart, that's a completely different curve than what's generally been discussed... though that data is probably much more useful in determining how we're doin, but in a very delayed fashion (since deaths probably happen at least 2 weeks after initial infections)... What's probably even more useful is data on severe (enough) cases that need hospitalization -- that's actually the real issue (short of coming up w/ an actual cure)... unless we can actually test everyone or do statistically valid, representative randomized testing.

_Man_

PS: Very glad to see you're feeling significantly better (in the other thread), Adam!
 
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Wayne_j

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And the deaths are lagging a couple of weeks after the positive tests.
 

Adam Lenhardt

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University of Minnesota, Mayo Clinic ready COVID-19 antibody tests in state

This is potentially huge for ending the nationwide shutdown and getting the country moving again. There are a huge number of people (like me!) who might have had COVID-19 but were unable to get tested due to inadequate supply. If they can check us after the fact and tell us whether we have the antibodies or not, then we can know whether we are immune or not.
 

Malcolm R

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I've noticed the stores that remain open around here have mostly closed their public restrooms. I suppose that's probably to minimize use and help protect store employees (and probably to maintain some social distancing that might be compromised in a small room), but it seems counter to the advice that we keep seeing to wash your hands frequently. If you're out shopping, and there are no public facilities available, where are you supposed to wash your hands? Especially if you don't happen to have any hand sanitizer?

Some stores do have sanitizer dispensers available, but not all.
 

LeoA

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Another good sign is the rate of hospitalizations in New York. We've gone from doubling every two days all the way to six days the last I saw.
 

Josh Steinberg

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That’s not necessarily because there are less infections. It’s because the hospitals are full and many don’t have capacity to take more patients.
 

LeoA

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Many across the state aren't full, though. For instance up here in northern New York, there's apparently no hospitalized patients right now despite several dozen cases in areas like St. Lawrence County, Jefferson County, etc.

I haven't read that even NYC is turning people away now. I hope that's not happening.
 

Josh Steinberg

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The New York Times reported yesterday that paramedics responding to 911 calls have to make decisions on the spot which patients to take and which to leave, whereas in the past they’d pretty much take everyone, because of the limited capacity at hospitals. I know the hospital across the street from me in Queens has set up two large tents with patient beds on the street in front of them, and are now also diverting patients to a makeshift hospital in Central Park. I’m sure it must vary from neighborhood to neighborhood, but from what I’m seeing locally, it seems that if there are beds available that’s more the result of the extraordinary work to make extra space rather than a decrease in demand. It may not be that they’re literally closing the door in people’s faces; it may be more that they’re just telling most people not to bother coming, and those who do come with only mild or moderate symptoms are being sent home untested and told to rest and isolate and only come back if they’re in acute distress.
 

SamT

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Dr. Paul Offit, the co-inventor of the successful rotavirus vaccine, put it more bluntly.

"When Dr. Fauci said 12 to 18 months, I thought that was ridiculously optimistic," he told CNN. "And I'm sure he did, too."

Vaccines development typically measured in years, not months.

  • Keymanthri Moodley, a professor of bioethics at Stellenbosch University in South Africa, said accelerated trials increase the odds of a high-profile failure, which can bring about other unintended consequences. "The risk of a failed vaccine to other well established immunisation programs is high," Moodley wrote in an email to CNN. "It would fuel the agenda of the anti-vax movement and deter parents from immunising their children with other safe vaccines."
  • In 2006, the vaccine co-developed by Offit was introduced for rotavirus -- which caused severe diarrhea in infants -- significantly blunting the disease. The entire effort spanned 26 years; the trial period took 16 years, he told CNN.
  • In November 2019, WHO prequalified a vaccine for Ebola, meaning health officials could start using it in at-risk countries, like the Democratic Republic of the Congo, where hundreds of thousands have been vaccinated. WHO said it was the fastest prequalification process it had ever conducted. The story of the vaccine's development is complex, but all told, it took about 5 years to get a licensed product, said Seth Berkley, CEO of Gavi, the Vaccine Alliance, in a recent TED interview.
  • Even back in the 1960s, when regulations were comparatively lax, it took 4 years for the mumps and measles vaccine to be approved, Offit said.
  • The SARS epidemic broke out in 2003, but it wasn't until 2016 that a vaccine -- developed by Hotez's team in Texas -- was ready for trial.
    "It looked really good -- it was protective, it was safe," Hotez, the dean of the National School of Tropical Medicine at the Baylor College of Medicine in Houston, told CNN. "But the problem was we couldn't raise any money."
 
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LeoA

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This isn't something normal. This is a worldwide global crisis crippling the world. Normal timelines can be thrown out the door, I'm sure.

Nobody thought we could mass produce 450' cargo ships with a construction time of 40 days. Yet such miracles and many others happened the last time the world faced a global crisis. The impossible suddenly became possible in so many different ways.

This isn't business as usual here. Far more resources will be getting poured into this, a lot of red tape is going to be cut through, etc.
 
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Josh Steinberg

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It’s true that this isn’t normal, but some of the vaccine development times can’t be shortened and it has nothing to do with the amount of resources people are willing to throw at it. Developing the vaccine takes time. Once that’s done, testing it takes time. It takes time for human test subjects to turn the vaccine injection into antibodies that protect against infections - weeks or months. Then those reactions have to be studied, and the vaccine adjusted based on findings. If they try to rush and avoid proper safety protocols and proper testing protocols, it could easily be a disaster for multiple reasons. If the vaccine doesn’t work but people getting it believe they’re protected, that’s a disaster. If the vaccine creates a bad reaction in the host, that’s a disaster. I have no doubt that scientists are working hard on it and that a lot of entities both public and private and throwing money at it. But there’s a limit to how quickly it can be accomplished.

That’s why we’re all on lockdown and doing social distancing. Without reliable access to tests to determine if one is carrying it, and without the ability to prevent it, everyone is both a potential carrier and a potential victim. What we need is time and patience. Time to let the scientists develop the proper testing for widespread use, patience to allow the vaccine process to play out as it needs to.
 

TJPC

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Here in the land of socialized medicine where no hospital or Doctor can refuse service, we hear a rumour that some private hospitals in the US are refusing service to covid19 cases. Is this actually true?
 

Adam Lenhardt

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Latest numbers from New York State:
Coronavirus_NewYorkState_20200331.png

(earlier dates available here)

1,550 confirmed fatalities -- 332‬ of which occurred just yesterday. Sixth consecutive day of triple-digit increases.

Here in the land of socialized medicine where no hospital or Doctor can refuse service, we hear a rumour that some private hospitals in the US are refusing service to covid19 cases. Is this actually true?
The federal government is requiring private hospitals that have dedicated ERs to, at a minimum, do the following:
  • Provide a medical screening exam (MSE) to every individual who comes to the ED for examination or treatment for a medical condition to determine if they have an emergency medical condition (EMC). An emergency medical condition is present when there are acute symptoms of sufficient severity such that the absence of immediate medical attention could reasonably be expected to result in serious impairment or dysfunction.
  • Provide necessary stabilizing treatment for individuals with an emergency medical condition EMC within the hospital’s capability and capacity; and
  • Provide for transfers of individuals with EMCs, when appropriate.
 

Malcolm R

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In Vermont, the governor has mandated that big box retailers restrict sales to essential items only, trying to cut down on the amount of shoppers in these stores. No more sales of electronics, clothing, beauty products, etc. Mostly just food, health, and home repairs, I guess. Not a huge impact, as we have only a handful of Walmarts, one Target, and one Costco, but I'm not sure how the retailers like it. It likely also means additional staff layoffs in these stores.

So the governor wants us to stay home, but I guess if your TV breaks down you're not allowed to buy another one, and you're not allowed to buy any DVD's to keep you or the kids entertained if you don't have streaming. If you need office supplies, a cable, or printer ink for work-from-home, you cannot buy that. If you need a new pair of sweatpants to be more comfortable working at home, you can't buy that. Or you at least have to order these things online and put more of the burden on warehouse workers and delivery folks.
 
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